Document Detail


Updating the chest pain algorithm: incorporating new evidence.
MedLine Citation:
PMID:  19050417     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In 2003, we published our chest pain protocol for the management of acute coronary syndromes (ACSs) and acute myocardial infarction. Our algorithm was specifically designed for our institution, which was primary percutaneous coronary intervention (PCI) for all ST-elevation myocardial infarctions (STEMIs) and a preferred invasive approach for non-STEMIs. Since 2003, there have been numerous changes in the adjunctive pharmacotherapeutic armamentarium for PCI in both the STEMI and non-STEMI ACS context. We present our updated chest pain algorithm with a brief review of the rapidly evolving changes in adjunctive pharmacotherapy for PCI and provide a rationale for the changes that we have made to our institutional protocol. Clinical pathways need to be consistently updated and revises by incorporating new evidence from clinical trials in order to maintain clinical relevance.
Authors:
Neil Goyal; Jennifer Stant; Francesca Esposito; Gina Piri; Michael Collins; Osman Sayan; Gerald Neuberg; Leslie Miller; Jeffery W Moses; Gregg W Stone; James Giglio; LeRoy E Rabbani
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Critical pathways in cardiology     Volume:  7     ISSN:  1535-2811     ISO Abbreviation:  Crit Pathw Cardiol     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-03     Completed Date:  2009-01-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101165286     Medline TA:  Crit Pathw Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  211-22     Citation Subset:  IM    
Affiliation:
Center for Interventional Vascular Therapy, Columbia University Medical Center, New York, NY 10032, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / diagnosis,  mortality,  therapy
Algorithms*
Angina, Unstable / diagnosis,  mortality,  therapy
Chest Pain / diagnosis,  mortality,  therapy*
Combined Modality Therapy
Critical Pathways / standards,  trends*
Evidence-Based Medicine
Female
Forecasting
Humans
Male
Myocardial Infarction / diagnosis,  mortality,  therapy
Myocardial Revascularization / methods*
Prognosis
Randomized Controlled Trials as Topic
Risk Assessment
Survival Analysis
Thrombolytic Therapy / methods*
Treatment Outcome
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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